Academic Medicine最新文献

{"title":"Interprofessional Debrief on Racism, Equity, and Microaggressions (I-DREAM): Using Simulation to Change Awareness, Attitudes, and Abilities Across an Institution.","authors":"Simranjeet S Sran, Heather Walsh, Dewesh Agrawal, Pallavi Dwivedi, Brandon Ho, Simmy King, Christina Lindgren, Rosalyn Manuel, Laura Nicholson, Gregory Yurasek, Pavan Zaveri","doi":"10.1097/ACM.0000000000005978","DOIUrl":"10.1097/ACM.0000000000005978","url":null,"abstract":"<p><strong>Purpose: </strong>Effective diversity, equity, and inclusion (DEI) education is imperative to combat bias across health care organizations. The authors evaluated the effectiveness of interprofessional, simulation-based DEI training in improving clinicians' awareness, attitudes, and abilities regarding bias, racism, inclusion, microaggressions, and equity in the workforce.</p><p><strong>Method: </strong>From October 2021 to June 2022, interprofessional clinicians at Children's National Hospital in Washington, DC, completed the Interprofessional Debrief on Racism, Equity, and Microaggressions (I-DREAM) training. Participants underwent small group training that included debriefing prerecorded simulations depicting language barriers, microaggressions, and other biased interactions. They were offered optional surveys before training, after training, and at 3-month follow-up. Participants' awareness and attitudes of the events were assessed. Additional data were collected from monthly use of telephone interpreter services.</p><p><strong>Results: </strong>A total of 1,811 interprofessional participants completed the I-DREAM training. Through user-generated codes, 759 presurveys and postsurveys and 276 presurveys and 3-month follow-up surveys were linked. Among these participants, 451 (60%) witnessed bias events before training and 629 (83%) after training (odds ratio [OR], 9.37; 95% CI, 5.77-15.22; P < .001), and 278 (37%) reported personally experiencing these events before training vs 496 (66%) after training (OR, 7.86; 95% CI, 5.45-11.33; P < .001). Participants reporting confidence responding to bias events increased from 388 (45%) to 556 (73%) (OR, 3.28; 95% CI, 2.52-4.27; P < .001). At 3 months, 199 participants (72%) continued to express confidence in responding (OR, 3.98; 95% CI, 2.56-6.18; P < .001). Use of language interpretation increased during training (mean difference in calls per month, 261; 95% CI, 124-398; P < .001; mean difference in minutes per month, 2,249; 95% CI, 616-3,882; P = .009).</p><p><strong>Conclusions: </strong>I-DREAM training was associated with improved clinicians' awareness of bias events in the workplace, confidence in ability to respond to these events, and delivery of language-equitable care.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"741-746"},"PeriodicalIF":5.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on \"Let Me Hold Your Breath\".","authors":"Anneliese Mair","doi":"10.1097/01.ACM.0001115220.81858.ad","DOIUrl":"https://doi.org/10.1097/01.ACM.0001115220.81858.ad","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":"100 6","pages":"683"},"PeriodicalIF":5.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Hologram-Based Augmented Reality in Anatomy Learning: The TEACHANATOMY Randomized Trial.","authors":"Lukas Zingg, Melanie Häusler, Jonas Hein, Sascha Jecklin, Sören Kottner, Dominic Gascho, Nicola Cavalcanti, Phillippe Voinov, Tobias Götschi, Fabio Carrillo, Florian Lagler, Philipp Fürnstahl, Mazda Farshad","doi":"10.1097/ACM.0000000000006012","DOIUrl":"10.1097/ACM.0000000000006012","url":null,"abstract":"<p><strong>Purpose: </strong>Augmented reality (AR) can generate realistic holograms overlaid on the real-word environment to provide an interactive learning experience. However, further research is needed to assess the impact of such technologies on knowledge acquisition. This study aims to evaluate the efficacy of an AR learning application in anatomy education.</p><p><strong>Method: </strong>TEACHANATOMY, a controlled, randomized trial, was conducted from September 14-October 24, 2022, at the University of Zurich and the Swiss Federal Institute of Technology. It included first- and second-year medical students with no prior anatomy education and compared learning with an interactive hologram-based AR learning module-incorporating adaptive learning and gamification elements-with traditional learning (TL) methods including textbooks, videos, and online resources. Forty-eight participants were randomly allocated to the AR or TL group. The primary outcome consisted of the scores on the theoretical and practical knowledge tests. Secondary outcomes included adverse health symptoms and user experience.</p><p><strong>Results: </strong>The AR group performed significantly better on both theoretical (median [IQR] scores: AR: 18.8 [16.6-20.0]; TL: 9.4 [7.7-11.3]; P < .001) and practical (AR: 14.0 [12.3-14.7]; TL: 5.0 [4.0-6.0]; P < .001) knowledge tests. The most common adverse health symptoms were headache, reported by 13/24 (54.2%) TL participants and 9/24 (37.5%) AR participants, and fatigue, and experienced by 13/24 (54.2%) TL participants and 2/24 (8.3%) AR participants. All participants evaluated learning with TEACHANATOMY as a positive experience, rating it as efficient and easy to understand. All participants agreed learning with AR can be beneficial in learning anatomy, with 89.6% (43/48) and 100% (48/48) expressing willingness to use AR as a learning tool for theoretical and practical anatomy learning, respectively.</p><p><strong>Conclusions: </strong>Findings show a short-term learning benefit with the use of the TEACHANATOMY learning application, thus supporting the implementation of interactive hologram-based AR technologies to improve knowledge in anatomy education.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"695-704"},"PeriodicalIF":5.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Data Adequacy in Qualitative Research Studies.","authors":"Danica Sims, Francois Cilliers","doi":"10.1097/ACM.0000000000005972","DOIUrl":"10.1097/ACM.0000000000005972","url":null,"abstract":"<p><p>When undertaking qualitative research studies, researchers often use the concept of data saturation to justify sufficient sampling to cease data collection and analysis. We argue that this reveals a positivist perspective that is incompatible with qualitative research, 1 which is instead based on constructivist, interpretivist, or other perspectives. Instead, we recommended the concepts of information power , 2conceptual depth , 3 and theoretical sufficiency , 1,4,5 with data adequacy considered during research design and evaluated iteratively throughout the sampling, data collection, and analysis processes. The table below provides guidelines for when more, or less, data are needed to justify cessation of data collection and analysis. Both researchers and readers can use the criteria for assessing data adequacy.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"758"},"PeriodicalIF":5.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Being Human: Envisioning the Future of Museum-Based Education for Health Professionals.","authors":"Sean Tackett, Kamna S Balhara, Toni Ungaretti, Philip Yenawine, Margaret S Chisolm","doi":"10.1097/ACM.0000000000006002","DOIUrl":"10.1097/ACM.0000000000006002","url":null,"abstract":"<p><strong>Abstract: </strong>The arts and humanities are fundamental to health professions education and can substantially enhance clinician empathy, tolerance for ambiguity, and openness to new perspectives. Museum-based education for health professionals (MBE-HP) has particular potential to achieve these aims but remains a nascent field of practice and study. To catalyze the growth of MBE-HP, a convening of 50 individuals from the United States and Canada, including museum educators and health professions educators, administrators, researchers, and learners, as well as patrons of the arts, was held for 3 days in December 2023 in Washington, DC. Activities included 7 distinct MBE-HP experiences at 5 national museums as well as facilitated discussions. This article describes the purpose and design of this unique gathering and summarizes its key outcomes. Through their shared experiences and discussions, participants developed a definition of MBE-HP as an approach that can occur in museums, other in-person settings, and/or online, which is informed by museum-based education adapted for health professional learners and involves exploring and/or creating visual and other forms of art, as well as individual and group reflection on these activities. Participants also developed strategies to advance MBE-HP and steps that can be taken by individuals, programs, and institutions involved in health professions education, as well as changes that may influence health professions education systems, such as professional organizations' sponsorship, private and public funding, evidence generation through research, and changes to regulations and policymaking. Museum-based education for health professionals is reaching critical mass, backed by science and supported by an increasing collection of resources for health professions educators; the definitions and strategies outlined here may be of value to stakeholders seeking to move MBE-HP into the mainstream to realize its potential to benefit learners, educators, patients, and communities.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"673-678"},"PeriodicalIF":5.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appraising Simulation-Based Approaches to Addressing Microaggressions in the Clinical Environment.","authors":"Jennifer Wood, Thom O'Neill, Katie Hughes","doi":"10.1097/ACM.0000000000006033","DOIUrl":"10.1097/ACM.0000000000006033","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"652"},"PeriodicalIF":5.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply to Balon.","authors":"William T Mallon, Natalya Cox","doi":"10.1097/ACM.0000000000006037","DOIUrl":"10.1097/ACM.0000000000006037","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"653-654"},"PeriodicalIF":5.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting Ready for Residency: A Qualitative Analysis of Fourth-Year Medical Student Learning Plans Mapped to Accreditation Council for Graduate Medical Education Residency Competencies.","authors":"Hannah L Mallaro, Celia Laird O'Brien, Sandra M Sanguino, Brigid M Dolan","doi":"10.1097/ACM.0000000000005997","DOIUrl":"10.1097/ACM.0000000000005997","url":null,"abstract":"<p><strong>Purpose: </strong>Undergraduate medical education (UME) to graduate medical education (GME) transition gaps may limit opportunities for learner improvement along each individual's learning trajectory. Additional information regarding learner perspectives on skill-based learning goals in preparation for the residency transition is needed. The authors hypothesized that fourth-year medical student (MS4) learning plans may provide information to fill the gap in understanding learner perspectives on the knowledge, skills, and opportunities they consider important in supporting their residency readiness.</p><p><strong>Method: </strong>Directed thematic analysis informed by a constructivist analytical approach was used to review readiness for residency reflections as part of a portfolio assessment system at a large, urban, research-intensive medical school during academic years 2021 and 2022. The authors identified student-selected Accreditation Council for Graduate Medical Education (ACGME) competencies and subcompetencies, iteratively identified non-subcompetency-based themes, refined the codes, and achieved consensus. They then analyzed the frequency of competencies and subcompetencies within learner reflections and explored additional themes.</p><p><strong>Results: </strong>In the final set of 291 reflections, the ACGME competencies selected for MS4 learning plans were patient care (227 learning plans), medical knowledge (144 learning plans), interpersonal and communication skills (94 learning plans), practice-based learning and improvement (79 learning plans), system-based practice (67 learning plans), and professionalism (63 learning plans). The top 3 ACGME subcompetencies identified as growth areas by MS4s were practice-based learning and improvement: evidence-based and informed practice, patient care: clinical reasoning, and interpersonal and communication skills: interprofessional and team communication. Teaching was the most common learning goal outside the ACGME subcompetencies.</p><p><strong>Conclusions: </strong>The MS4 readiness for residency reflections offered important insight into student perspectives on UME to GME transition preparation. Learners' reflections yielded a diverse set of learning goals for the fourth year of medical school, highlighting the importance of individualized approaches in addition to standardized curricula at the time of transition.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"710-717"},"PeriodicalIF":5.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Examination of Grade Appeals Via a Root Cause Analysis.","authors":"Samara B Ginzburg, Aubrie Swan Sein, Jonathan M Amiel, Lisa Auerbach, Todd Cassese, Lyuba Konopasek, Allison B Ludwig, Mimoza Meholli, Robin Ovitsh, Judith Brenner","doi":"10.1097/ACM.0000000000006000","DOIUrl":"10.1097/ACM.0000000000006000","url":null,"abstract":"<p><strong>Abstract: </strong>Undergraduate medical educators seek to optimize student learning, improve grading transparency and fairness, and provide useful information to residency programs. Recently, the United States Medical Licensing Examination's shift to pass/fail scoring for step 1 disrupted curricular and assessment operations, and schools' tiered grading practices have been scrutinized. In noting that significant institutional time and energy were being expended in addressing the current levels of student grade appeals, 6 public and private medical schools in the Northeastern United States engaged in an examination of grade appeals via a root cause analysis (RCA). From November 2021 to April 2022, the authors reviewed specific instances of grading challenges that the team of educators encountered previously. From May to June 2022, the authors met for a facilitated discussion of the question, \"Why are students challenging grading processes and systems or outcomes?\" From July to October 2022, the authors identified root causes by analyzing results from the fishbone diagram (process, equipment, materials, people, and environment) and using the \"five whys\" technique. Several potential explanations for grade appeals and challenging grading systems across institutions were identified, including variability in the quality or experience of evaluators, lack of clarity about the goals and expectations of clerkships and a lack of transparency about the grading process, having a tiered grading system, technical issues with equipment, and clinical productivity demands of faculty. In proposing solutions to root causes identified in the RCA, factors were mapped to Liaison Committee on Medical Education (LCME) standards to facilitate quality and process improvements in grading. Aiming to support the learning environment and a fair and equivalent assessment process, the authors present a novel RCA and LCME method that can contribute to improving grading systems and has the potential to enhance learning and success.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"666-672"},"PeriodicalIF":5.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Competency-Based, Time-Variable Mid-Career Fellowship Program in Hospice and Palliative Medicine.","authors":"Janae K Heath, Shannon Devlin, Richard E Leiter, Elizabeth Lindenberger, Jaclyn Shameklis, Laura Dingfield","doi":"10.1097/ACM.0000000000005998","DOIUrl":"10.1097/ACM.0000000000005998","url":null,"abstract":"<p><strong>Problem: </strong>The field of hospice and palliative medicine (HPM) is grappling with a significant workforce shortage. An untapped source of growth for the HPM specialist workforce is mid-career physicians interested in specialist training and certification. This study describes a pilot competency-based, time-variable (CBTV) fellowship program for mid-career physicians interested in HPM, called the Mid-Career Fellowship.</p><p><strong>Approach: </strong>The pilot program was approved by the Accreditation Council for Graduate Medical Education (ACGME) Advancing Innovation in Residency Education program in consultation with certification boards. The Mid-Career Fellowship enrolled 2 mid-career fellows in July 2019 at the University of Pennsylvania, ultimately expanding in July 2020 and July 2021 to 7 participating sites. Clinical training in the fellowship was scheduled on an interrupted, part-time basis, with full- or partial-week clinical HPM rotations scheduled to accommodate fellows' other professional and academic responsibilities. Mid-career fellows' progression on HPM competencies was assessed through direct observation during HPM clinical rotations using validated assessments and the ACGME HPM milestones framework. Participants and traditional HPM fellows were surveyed for their perceptions of the program.</p><p><strong>Outcomes: </strong>From July 2019 to June 2024, the Mid-Career Fellowship had enrolled 22 individuals and produced 14 graduates across the 7 participating sites. As of June 2024, 12 of 14 (86%) graduates had entered full- or part-time practice in an HPM specialty. Two mid-career fellows have passed the biannual HPM board certification, with additional fellows being eligible to sit for the certification exam in fall 2024.</p><p><strong>Next steps: </strong>Aspects of the program could be adapted by other specialties facing workforce shortages. Future work is needed to determine the long-term impact of this training and the role of similar programs in other specialties. The authors' next steps will be to conduct qualitative analyses of such programs' impact on professional development for participants.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"684-688"},"PeriodicalIF":5.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}